HIV-indicator-condition-driven HIV testing: clinically effective but still rarely implemented.

Area of Science:

• Public Health
• Infectious Diseases
• Clinical Medicine

Background:

• Excellent outcomes for people living with HIV in the UK contrast with high rates of undiagnosed and late diagnoses.
• HIV indicator conditions, encompassing AIDS-defining and non-AIDS-defining illnesses, are associated with HIV infection due to shared risk factors or immunodeficiency.
• Current HIV testing strategies require improvement to address the significant burden of undiagnosed and late diagnoses.

Purpose of the Study:

• To review the evidence supporting routine HIV testing in patients presenting with indicator conditions.
• To highlight the clinical effectiveness and cost-effectiveness of this HIV testing strategy.
• To advocate for the broad implementation of routine HIV testing in indicator conditions to reduce undiagnosed and late HIV diagnoses.

Main Methods:

• Review of emerging evidence on the value of routine HIV testing in indicator conditions.
• Analysis of clinical effectiveness, cost-effectiveness, and patient/practitioner acceptability.
• Examination of public health impact at a population level.

Main Results:

• Routine HIV testing in indicator conditions is clinically effective, as HIV status is crucial for managing various illnesses.
• The strategy is cost-effective when HIV prevalence exceeds 0.1%.
• This approach eliminates the need for risk assessment and is acceptable to patients and healthcare providers.

Conclusions:

• Routine HIV testing in indicator conditions is a valuable strategy to reduce undiagnosed and late HIV diagnoses in the UK.
• Implementation can improve patient management and public health outcomes.
• The approach is evidence-based, cost-effective, and acceptable to stakeholders.